IBCC – Acute Liver Failure

xloma.fota.13 shared this article with you from Inoreader IBCC – Acute Liver Failure Via EMCrit Blog - Emergency Department Critical Care Acute liver failure is rare, but when it does occur it requires an organized diagnostic and therapeutic approach.  Success often relies upon aggressive support of other organs (e.g. renal failure and management of intracranial hypertension). The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes EMCrit Project by Josh Farkas. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Molecular landscape of IDH-mutant primary astrocytoma Grade IV/glioblastomas

xloma.fota.13 shared this article with you from Inoreader Molecular landscape of <i>IDH</i>-mutant primary astrocytoma Grade IV/glioblastomas Via Modern Pathology - AOP - nature.com science feeds Modern Pathology, Published online: 10 March 2021; doi:10.1038/s41379-021-00778-x Molecular landscape of IDH-mutant primary astrocytoma Grade IV/glioblastomas View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bone-conduction threshold and air-bone gap may predict frequency-specific air-conduction threshold after tympanoplasty

xloma.fota.13 shared this article with you from Inoreader Bone-conduction threshold and air-bone gap may predict frequency-specific air-conduction threshold after tympanoplasty Via Ear infections by Ethan I. Huang, Yu-Chieh Wu, Hsiu-Mei Chuang, Tzu-Chi Huang Postoperative hearing improvement is one of the main expectations for patients receiving tympanoplasty. The capacity to predict postoperative hearing may help to counsel a patient properly and avoid untoward expectations. It is difficult to predict postoperative hearing without knowing the disease process in the middle ear, which can only be assessed intraoperatively. However, the duration and extent of the underlying pathologies may represent in bone-conduction threshold and air-bone gap. Here in patients undergoing tympanoplasty without ossiculoplasty, we sorted and separated the surgery dates into the first group to build the predicting models and the second group to test the predictions. There were 87 and 30 ears, respectively. No specific enrollment or exclusion criteria were based on underlying pathologies such as the perforation size of the tympanic membrane or the middle ear conditions. The results show that bone-conduction threshold and air-bone gap together predicted air-co nduction threshold after the surgery, including each frequency of 0.5k, 1k, 2k, and 4k Hz. The discrepancies between the predictions and recordings did not differ among these four frequencies. Of the variance in mean postoperative air-conduction threshold, 56.7% was linearly accounted for by these two preoperative predictors in this sample. The results suggest a trend that, the higher the frequency, the larger the part was accounted for by these two preoperative predictors. These together may help a surgeon to estimate frequency-specific hearing outcome after the surgery, answer patients' questions with quantitative statistics, and counsel patients with proper expectations. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Parent mediated intervention programmes for children and adolescents with neurodevelopmental disorders in South Asia: A systematic review

xloma.fota.13 shared this article with you from Inoreader Parent mediated intervention programmes for children and adolescents with neurodevelopmental disorders in South Asia: A systematic review Via Speech therapy by Kamrun Nahar Koly, Susanne P. Martin-Herz, Md. Saimul Islam, Nusrat Sharmin, Hannah Blencowe, Aliya Naheed Objective Parent-mediated programmes have been found to be cost effective for addressing the needs of the children and adolescents with Neurodevelopmental Disorders (NDD) in high-income countries. We explored the impact of parent-mediated intervention programmes in South Asia, where the burden of NDD is high. Methods A systematic review was conducted using the following databases; PUBMED, MEDLINE, PsycINFO, Google Scholar and Web of Science. Predefined MeSH terms were used, and articles were included if published prior to January 2020. Two independent researchers screened the articles and reviewed data. Outcomes measures The review included studies that targeted children and adolescents between 1 and 18 years of age diagnosed with any of four specific NDDs that are commonly reported in South Asia; Autism Spectrum Disorder (ASD), Intellectual Disability (ID), Attention Deficit Hyperactivity Disorder (ADHD) and Cerebral Palsy (CP). Studies that reported on parent or ch ild outcomes, parent-child interaction, parent knowledge of NDDs, or child activities of daily living were included for full text review. Results A total of 1585 research articles were retrieved and 23 studies met inclusion criteria, including 9 Randomized Controlled Trials and 14 pre-post intervention studies. Of these, seventeen studies reported effectiveness, and six studies reported feasibility and acceptability of the parent-mediated interventions. Three studies demonstrated improved parent-child interaction, three studies demonstrated improved child communication initiations, five studies reported improved social and communication skills in children, four studies demonstrated improved parental knowledge about how to teach their children, and four studies reported improved motor and cognitive skills, social skills, language development, learning ability, or academic performance in children. Conclusion This systematic review of 23 studies demonstrated improvements in parent and child skills following parent-mediated intervention in South Asia. Additional evaluations of locally customized parent-mediated programmes are needed to support development of feasible interventions for South Asian countries. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Two birds with one stone.–Addressing depressive symptoms, emotional tension and worry improves tinnitus-related distress and affective pain perceptions in patients with chronic tinnitus

xloma.fota.13 shared this article with you from Inoreader Two birds with one stone.–Addressing depressive symptoms, emotional tension and worry improves tinnitus-related distress and affective pain perceptions in patients with chronic tinnitus Via Tinnitus by Benjamin Boecking, Matthias Rose, Petra Brueggemann, Birgit Mazurek Background Psychological factors link the co-occurrence of tinnitus-related distress and pain perceptions in patients with chronic tinnitus. Objective This study examines, if treatment-related changes in these factors ameliorate both tinnitus-related distress and pain perceptions in a sample of patients with chronic tinnitus. Methods N = 1238 patients with chronic tinnitus provided pre- and post-treatment ratings of tinnitus-related distress and affective or sensory pain perceptions alongside measures of depressive symptoms and perceived stress. Treatment comprised an intensive tinnitus-specific multimodal treatment program. Using serial indirect-effects analyses, we examined association patterns between baseline values and change rates of those variables that were found to respond to treatment. Results Small effect sizes emerged for changes in tinnitus-related distress, affective (but not sensory) pain perceptions, depressive symptoms, emotional tensio n and worry. At pre- or post-treatment respectively, baseline values and change rates intercorrelated. Across timepoints, (1) baseline tinnitus-related distress and affective pain perceptions were positively associated with improvements in tinnitus-related distress, affective pain perceptions and depressive symptoms. (2) Baseline depressive symptoms or emotional tension mediated positive associations between baseline tinnitus-related distress and improvement in affective pain perceptions. (3) Change in depressive symptoms mediated the effect of baseline tinnitus-related distress on change in affective pain perceptions–partly through associated change in emotional tension or worry. Mood-independent aspects of emotional tension were negatively associated with improvement in affective pain perceptions. Conclusions Depressive symptoms, emotional tension and worry emerge as key predictors of treatment response and transdiagnostic treatment targets for alleviating tinnitus-related distress and functionally associated affective pain perceptions. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tinnitus treatment by vagus nerve stimulation: A systematic review

xloma.fota.13 shared this article with you from Inoreader Tinnitus treatment by vagus nerve stimulation: A systematic review Via Tinnitus by I. Stegeman, H. M. Velde, P. A. J. T. Robe, R. J. Stokroos, A. L. Smit Background Tinnitus is a phantom sensation of sound, which can have a negative impact on quality of life of those affected. No curative treatments are currently known. Neuromodulation by vagus nerve stimulation has emerged as a new treatment option for tinnitus, though till date the effectiveness remains unclear. Therefore, we aim to review the effect of vagus nerve stimulation on tinnitus distress and tinnitus symptom severity in patients with chronic tinnitus. Methods We searched Pubmed, Embase and the Cochrane Library systematically for RCTs, observational studies and case studies on the effect of VNS treatment for tinnitus on October 29, 2019. Studies including adult patients with subjective tinnitus, comparing transcutaneous or implantable VNS to placebo or no treatment or before and after application of VNS treatment on tinnitus distress and tinnitus symptom severity measured with a validated questionnaire were eligible. The risk of bias was assessed with the appropri ate tool for each type of study. Results Our search identified 9 primary studies of which 2 RCTs, 5 cohort studies and 2 case series or reports. 5 studies used transcutaneous VNS treatment and 4 used implanted VNS treatment. 6 studies combined VNS treatment with sound therapy. There was a serious risk of bias in all studies, especially on confounding. Most studies reported a small decrease in tinnitus distress or tinnitus symptom severity. Conclusion Due to methodological limitations and low reporting quality of the included studies, the effect of VNS on tinnitus remains unclear. To draw conclusions for which patient population and to what extent (t)VNS is beneficial in the treatment of tinnitus, a randomised controlled trial should be considered. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Providing open-label placebos remotely—A randomized controlled trial in allergic rhinitis

xloma.fota.13 shared this article with you from Inoreader Providing open-label placebos remotely—A randomized controlled trial in allergic rhinitis Via Rhinitis by Tobias Kube, Verena E. Hofmann, Julia A. Glombiewski, Irving Kirsch Background Placebos can reduce physical symptoms even when provided with full honesty and disclosure. Yet, the precise mechanisms underlying the effects of "open-label placebos" (OLPs) have remained subject of debate. Furthermore, it is unclear whether OLPs are similarly effective when provided remotely, as is sometimes required e.g. in the current COVID-19 pandemic. Methods In a randomized-controlled trial, we examined the effects of OLP plus treatment as usual (TAU) compared to TAU alone on symptom reduction in people with allergic rhinitis (N = 54) over the course of two weeks. Due to the COVID-19 pandemic, OLP was provided remotely (i.e. sent via postal service). To investigate the potential influence of the clinical encounter on the effects of OLP, we manipulated the perception of the virtual clinical encounter, both with respect to verbal and nonverbal factors (augmented vs. limited encounter). Results The results of the manipulation check confirmed that the augmented clinical encounter was evaluated more positively than the limited encounter, in terms of perceived warmth of the provider. Participants from all treatment groups showed significant symptom reduction from baseline to two weeks later, but OLP had no incremental effect over TAU. Participants benefitted more from OLP when they did not take any other medication against allergic symptoms than when taking medication on demand. When controlling for baseline symptoms, a significant treatment by encounter interaction was found, pointing to greater symptom improvement in the OLP group when the encounter was augmented, whereas the control group improved more when the encounter was limited. Discussion The study demonstrates that providing OLP and enhancing the encounter remotely is possible, but their effectiveness might be lower in comparison to previous studies relying on physical patient-provider interaction. The study raises questions for future research about the p otential and challenges of remote placebo studies and virtual clinical encounters. The study has been registered as a clinical trial at ISRCTN (record number: 39018). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

PulmCrit Wee: High-titer convalescent plasma fails again for hospitalized COVID patients

xloma.fota.13 shared this article with you from Inoreader PulmCrit Wee: High-titer convalescent plasma fails again for hospitalized COVID patients Via EMCrit Blog - Emergency Department Critical Care Convalescent plasma use against epidemic respiratory viruses dates back to the influenza pandemic of 1918.  This intervention has persisted for over a century based on high face-validity, rather than any high-quality evidence.  The COVID epidemic reignited enthusiasm for this therapy, leading to its use in tens of thousands of patients (e.g., an expanded-use program organized […] EMCrit Project by Josh Farkas. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

PulmCrit Wee – Therapeutic anticoagulation for COVID ICU patients: Is the heparin vial half empty, or half full?

xloma.fota.13 shared this article with you from Inoreader PulmCrit Wee – Therapeutic anticoagulation for COVID ICU patients: Is the heparin vial half empty, or half full? Via EMCrit Blog - Emergency Department Critical Care A fresh preprint reveals the results of combining three trials to evaluate therapeutic anticoagulation among severe COVID patients (defined as patients requiring high flow nasal cannula, noninvasive ventilation, intubation, vasopressors, or inotropes).  Patients were randomized to therapeutic anticoagulation versus thromboprophylaxis per usual care guidelines.  REMAP-CAP also simultaneously randomized some patients to receive aspirin as well.  […] EMCrit Project by Josh Farkas. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

NUTM1-rearranged colorectal sarcoma: a clinicopathologically and genetically distinctive malignant neoplasm with a poor prognosis

xloma.fota.13 shared this article with you from Inoreader <i>NUTM1</i>-rearranged colorectal sarcoma: a clinicopathologically and genetically distinctive malignant neoplasm with a poor prognosis Via Modern Pathology - AOP - nature.com science feeds Modern Pathology, Published online: 13 March 2021; doi:10.1038/s41379-021-00792-z NUTM1-rearranged colorectal sarcoma: a clinicopathologically and genetically distinctive malignant neoplasm with a poor prognosis View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A prognostic score for non-small cell lung cancer resected after neoadjuvant therapy in comparison with the tumor-node-metastases classification and major pathological response

xloma.fota.13 shared this article with you from Inoreader A prognostic score for non-small cell lung cancer resected after neoadjuvant therapy in comparison with the tumor-node-metastases classification and major pathological response Via Modern Pathology - AOP - nature.com science feeds Modern Pathology, Published online: 13 March 2021; doi:10.1038/s41379-021-00777-y A prognostic score for non-small cell lung cancer resected after neoadjuvant therapy in comparison with the tumor-node-metastases classification and major pathological response View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

IBCC – Acute on Chronic Liver Failure (ACLF)

xloma.fota.13 shared this article with you from Inoreader IBCC – Acute on Chronic Liver Failure (ACLF) Via EMCrit Blog - Emergency Department Critical Care Acute on Chronic Liver Failure (ACLF) refers to decompensated cirrhosis causing failure of at least two organs (e.g. hepatic encephalopathy, hepatorenal syndrome, shock, or respiratory failure).  It may be useful to conceptualize these patients as having ACLF (rather than, for example, hepatic encephalopathy plus hepatorenal syndrome), because this provides a more accurate global understanding of […] EMCrit Project by Josh Farkas. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.